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目的探讨磁敏感加权成像(susceptibility-weighted imaging,SWI)对脑梗死侧支循环监测的敏感性及其临床应用价值。资料与方法对36例(男19例,女17例,年龄20～83岁,平均65岁)脑梗死各期(超急性期<6h,急性期7～24h,亚急性期1.5～7天,稳定期8～14天,慢性期>15天)患者进行SWI及随诊检查。观察各期脑梗死在SWI图上的表现,观察脑梗死后侧支循环血管的显示及显示程度,得出相应临床NIHSS评分,并进行相关统计学分析。结果 26例显示侧支循环血管的存在,占72%。2级显示11例(占31%),显示程度与临床NIHSS评分改变有明显相关性(rs=0.681,P=0.001)。结论 SWI能够敏感显示脑梗死后参与侧支循环的微小血管;通过梗死灶周围微小血管的显示程度不同,有助于判断其周围血流再灌注情况,对临床的治疗及预后起到一定的预测作用。
Objective To investigate the sensitivity and clinical value of susceptibility-weighted imaging (SWI) in detecting collateral circulation in patients with cerebral infarction. Materials and Methods Thirty-six patients (19 males and 17 females, aged 20-83 years old, average 65 years old) were divided into three groups: acute phase <6h, acute phase 7-24h, subacute phase 1.5-7 days, Stable for 8 to 14 days, chronic> 15 days) patients with SWI and follow-up examination. Observe the manifestation of cerebral infarction on SWI, and observe the display of the collateral circulation blood vessels after cerebral infarction. Obtain the corresponding clinical NIHSS score, and make relevant statistical analysis. Results 26 cases showed the presence of collateral vessels, accounting for 72%. Level 2 showed 11 cases (31%), showing a significant correlation with clinical NIHSS score changes (rs = 0.681, P = 0.001). Conclusion SWI can sensitively show the microvessels involved in collateral circulation after cerebral infarction. It is helpful to judge the peripheral blood flow and reperfusion through the different degree of the display of microvessels around the infarct, which can predict the clinical treatment and prognosis effect.